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https://www.readbyqxmd.com/read/28449316/does-my-high-blood-pressure-improve-your-survival-overall-and-subgroup-learning-curves-in-health
#1
Raf Van Gestel, Tobias Müller, Johan Bosmans
Learning curves in health are of interest for a wide range of medical disciplines, healthcare providers, and policy makers. In this paper, we distinguish between three types of learning when identifying overall learning curves: economies of scale, learning from cumulative experience, and human capital depreciation. In addition, we approach the question of how treating more patients with specific characteristics predicts provider performance. To soften collinearity problems, we explore the use of least absolute shrinkage and selection operator regression as a variable selection method and Theil-Goldberger mixed estimation to augment the available information...
April 27, 2017: Health Economics
https://www.readbyqxmd.com/read/28447582/training-the-next-generation-of-canadian-clinician-scientists-charting-a-path-to-success
#2
Charles Yin, Patrick E Steadman, Tavis Apramian, Tianwei E Zhou, Abdullah Ishaque, Xin Wang, Alexandra Kuzyk, Nebras Warsi
Clinician-scientists are physicians with training in both clinical medicine and research that enables them to occupy a unique niche as specialists in basic and translational biomedical research. While there is widespread acknowledgement of the importance of clinician-scientists in today's landscape of evidence-based medical practice, training of clinician-scientists in Canada has been on the decline, with fewer opportunities to obtain funding. With the increasing length of training and lower financial compensation, fewer medical graduates are choosing to pursue such a career...
April 26, 2017: Clinical and Investigative Medicine. Médecine Clinique et Experimentale
https://www.readbyqxmd.com/read/28444455/prevalence-predictors-and-prognostic-implications-of-residual-impairment-of-functional-capacity-after-transcatheter-aortic-valve-implantation
#3
Mohammad Abdelghani, Rafael Cavalcante, Yosuke Miyazaki, Robbert J de Winter, Rogério Sarmento-Leite, José A Mangione, Alexandre Abizaid, Pedro A Lemos, Patrick W Serruys, Fabio S de Brito
BACKGROUND: Patients with degenerative aortic stenosis (AS) referred for transcatheter aortic valve implantation (TAVI) typically have advanced cardiac and vascular adverse remodeling and multiple comorbidities and, therefore, might not recover a normal functional capacity after valve replacement. We sought to investigate the prevalence, the predictors, and the prognostic impact of residual impairment of functional capacity after TAVI. METHODS AND RESULTS: Out of 790 patients undergoing TAVI with impaired functional capacity (NYHA II-IV) at baseline, NYHA functional class improved in 592 (86...
April 25, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28441646/spontaneous-regression-of-possible-transcatheter-aortic-valve-thrombosis-without-additional-anticoagulant-two-year-follow-up
#4
Ryo Yanagisawa, Kentaro Hayashida, Masahiro Jinzaki, Keiichi Fukuda
An 84-year-old man with symptomatic severe aortic stenosis received transcatheter aortic valve implantation (TAVI). Dual-antiplatelet therapy was continued for 6 months post TAVI, and aspirin alone was used thereafter. Four-dimensional multidetector computed tomography revealed a new hypoattenuated leaflet thickening (HALT) with reduced leaflet motion at 1 year, considered to indicate leaflet thrombosis. At the 2-year follow-up, leaflet mobility had improved, with spontaneous regression of HALT. This is the first report of confirmed spontaneous regression of possible transcatheter heart valve thrombosis and recovery of leaflet mobility without the need for additional anticoagulant...
May 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28438324/rikki-tikki-tavi-for-aortic-regurgitation
#5
EDITORIAL
Kevin L Greason
No abstract text is available yet for this article.
April 4, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28433958/feasibility-and-safety-of-vitamin-k-antagonist-monotherapy-in-atrial-fibrillation-patients-undergoing-transcatheter-aortic-valve-implantation
#6
Nicolas A Geis, Christina Kiriakou, Emmanuel Chorianopoulos, Sven T Pleger, Hugo A Katus, Raffi Bekeredjian
AIMS: We aimed to assess the efficacy and safety of vitamin K antagonist (VKA) monotherapy in atrial fibrillation (AF) patients undergoing transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: In 735 TAVIs since 2008 we identified 167 patients suffering from concomitant AF who received either VKA monotherapy (n=77), VKA plus single antiplatelet therapy (SAPT, n=41) or a triple anticoagulation regimen (n=49). Thromboembolic as well as bleeding complications were analysed for six months after TAVI...
April 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28433509/transcutaneous-aortic-valve-implantation-using-the-carotid-artery-access-feasibility-and-clinical-outcomes
#7
Zacharenia Kallinikou, Alexandre Berger, Patrick Ruchat, Gregory Khatchatourov, Isabelle Fleisch, Branislav Korkodelovic, Emmanuel Henchoz, René-Andréas Marti, Stéphane Cook, Mario Togni, Jean-Jacques Goy
BACKGROUND: Transcarotid access is an alternative route for transcutaneous aortic valve implantation (TAVI) in patients with impossible transfemoral access. AIMS: We evaluated the safety, effectiveness and early and late clinical outcomes of CoreValve(®) implantation via the common carotid artery. METHODS: Eighteen patients (10 men, 8 women; mean age 84±5 years) at high surgical risk (mean EuroSCORE II 16±13%) with significant peripheral artery disease underwent TAVI via common carotid artery access under general anaesthesia...
April 19, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28431442/-aortic-valve-stenosis-when-to-treat-interventionally-when%C3%A2-surgically
#8
Won-Keun Kim, Christian W Hamm
The mainstay for the current treatment of severe aortic stenosis includes surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI). In patients with high operative risk TAVI is established as first line therapy. New data on intermediate and low risk groups demonstrate at least non-inferiority of TAVI against SAVR, and in the near future a consistently rising number of transcatheter procedures may be anticipated. The purpose of this review is to outline the decision making process, hence to illustrate the diagnostic algorithm and to provide criteria for a differentiated approach against the background of recent data...
April 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28430920/rates-and-predictors-of-hospital-readmission-after-transcatheter-aortic-valve-implantation
#9
Anna Franzone, Thomas Pilgrim, Nicolas Arnold, Dik Heg, Bettina Langhammer, Raffaele Piccolo, Eva Roost, Fabien Praz, Lorenz Räber, Marco Valgimigli, Peter Wenaweser, Peter Jüni, Thierry Carrel, Stephan Windecker, Stefan Stortecky
Aims: To analyse reasons, timing and predictors of hospital readmissions after transcatheter aortic valve implantation (TAVI). Methods and Results: Patients included in the Bern TAVI Registry between August 2007 and June 2014 were analysed. Fine and Gray competing risk regression was used to identify factors predictive of hospital readmission within 1 year after TAVI with bootstrap analysis for internal validation. Of 868 patients alive at discharge, 221 (25.4%) were readmitted within 1 year...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28425248/the-effect-of-transcatheter-aortic-valve-implantation-on-mean-platelet-volume
#10
Mehmet Burak Özen, Hüseyin Ayhan, Hacı Ahmet Kasapkara, Telat Keleş, Tahir Durmaz, Kemal Eşref Erdoğan, Bilge Duran Karaduman, Serdal Baştuğ, Cenk Sari, Abdullah Nabi Aslan, Engin Bozkurt
BACKGROUND/AIM: Transcatheter aortic valve implantation (TAVI) is an innovative approach to the treatment of aortic stenosis (AS) as an alternative to surgery in high-risk patients. Mean platelet volume (MPV) is considered an indicator of endothelial dysfunction, platelet function, and activation. In this study, we aimed to investigate MPV changes in patients undergoing TAVI. MATERIALS AND METHODS: This study included 100 patients diagnosed with symptomatic severe AS and treated with TAVI between July 2011 and August 2013...
April 18, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28416501/protocol-for-a-placebo-controlled-within-participants-crossover-trial-evaluating-the-efficacy-of-intranasal-oxytocin-to-improve-pain-and-function-among-women-with-chronic-pelvic-musculoskeletal-pain
#11
Joshua A Rash, Kirsti Toivonen, Magali Robert, Maryam Nasr-Esfahani, John F Jarrell, Tavis S Campbell
INTRODUCTION: This protocol presents the rationale and design for a trial evaluating the efficacy of intranasal oxytocin in improving pain and function among women with chronic pelvic musculoskeletal pain. Oxytocin is a neuropeptide traditionally recognised for involvement in labour, delivery and lactation. Novel evidence suggests that oxytocin decreases pain sensitivity in humans. While oxytocin administration has been reported to lower pain sensitivity among patients experiencing chronic back pain, headache, constipation and colon pain, no research has evaluated the association between intranasal oxytocin and chronic pelvic musculoskeletal pain...
April 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28414654/left-ventricular-function-determines-the-survival-benefit-for-women-over-men-after-transcatheter-aortic-valve-implantation-tavi
#12
Timm Bauer, Helge Möllmann, Andreas Beckmann, Stephan Ensminger, Christian Frerker, David Holzhey, Alexander Berkowitsch, Ralf Zahn, Friedrich Mohr, Christian W Hamm, Thomas Walther
AIMS: There is evidence for a lower mortality in female patients after transcatheter aortic valve implantation (TAVI), but the underlying reasons for the gender- specific differences in prognosis are not well understood. In particular, the role of left ventricular dysfunction is unclear. METHODS AND RESULTS: From January 2011 to December 2013, a total of 15,616 patients treated with TAVI were prospectively enrolled in the German Aortic Valve Registry (GARY). For the present analysis female TAVI patients (N=8,456) were compared with male TAVI patients (N=7,160) with a particular focus on left ventricular ejection function (LVEF)...
April 18, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28411259/cerebral-embolic-protection-devices-during-transcatheter-aortic-valve-implantation-systematic-review-and-meta-analysis
#13
Rodrigo Bagur, Karla Solo, Saleh Alghofaili, Luis Nombela-Franco, Chun Shing Kwok, Samual Hayman, Reed A Siemieniuk, Farid Foroutan, Frederick A Spencer, Per O Vandvik, Tim G Schäufele, Mamas A Mamas
BACKGROUND AND PURPOSE: Silent ischemic embolic lesions are common after transcatheter aortic valve implantation (TAVI). The use of embolic protection devices (EPD) may reduce the occurrence of these embolic lesions. Thus, a quantitative overview and credibility assessment of the literature was necessary to draw a robust message about EPD. Therefore, the aim of this meta-analysis was to study whether the use of EPD reduces silent ischemic and clinically evident cerebrovascular events associated with TAVI...
April 14, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28411108/causes-and-temporal-trends-in-procedural-deaths-after-transcatheter-aortic-valve-implantation
#14
Zaven Terzian, Marina Urena, Dominique Himbert, Constance Gardy-Verdonk, Bernard Iung, Claire Bouleti, Eric Brochet, Walid Ghodbane, Jean-Pol Depoix, Patrick Nataf, Alec Vahanian
BACKGROUND: The causes of procedural deaths after transcatheter aortic valve implantation (TAVI) have been scarcely detailed. AIMS: To assess these causes and their temporal trends since the beginning of the TAVI era. METHODS: From October 2006 to April 2014, 601 consecutive high-risk/inoperable patients with severe aortic stenosis underwent TAVI using the Edwards SAPIEN or SAPIEN XT or the Medtronic CoreValve. The transfemoral route was the default approach; the transapical or left subclavian approaches were alternative options...
April 11, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/28408919/transcatheter-aortic-valve-implantation-a-revolution-in-the-therapy-of-elderly-and-high-risk-patients-with-severe-aortic-stenosis
#15
REVIEW
Teoman Kilic, Irem Yilmaz
Transcatheter aortic valve implantation (TAVI) represents a real revolution in the field of interventional cardiology for the treatment of elderly or high-risk surgical patients with severe symptomatic aortic valve stenosis. Today, TAVI seems to play a key and a reliable role in the treatment of intermediate and maybe low-risk patients with severe aortic stenosis. TAVI has also evolved from a complex and hazardous procedure into an effective and safe therapy by the development of new generation devices. This article aims to review the background and future of TAVI, clinical trials and registries with old and new generation TAVI devices and to focus on some open issues related to post-procedural outcomes...
March 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28408105/a-meta-analysis-of-effects-of-transcatheter-versus-surgical-aortic-valve-replacement-on-left-ventricular-ejection-fraction-and-mass
#16
Hisato Takagi, Tomo Ando, Takuya Umemoto
OBJECTIVES: To determine which procedure, transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR), for severe aortic stenosis (AS) improves follow-up left ventricular (LV) function or hypertrophy more effectively, we performed the first meta-analysis of comparative studies reporting LV ejection fraction (LVEF) or mass (LVM) after TAVI versus SAVR. METHODS: Studies considered for inclusion met the following criteria: the article was written in English; the design was a comparative study; the study population was patients with severe AS; patients were assigned to TAVI versus SAVR; and outcomes included follow-up (6-12-month) LVEF or LVM...
April 6, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28398399/-acute-aortic-dissection-during-ineffective-attempt-of-transcatheter-implant-of-a-fully-resheathable-respositionable-and-retrievable-aortic-valve
#17
Annamaria Dachille, Fortunato Iacovelli, Francesco Giardinelli, Emanuela De Cillis, Nicola Signore, Marco Matteo Ciccone, Stefano Favale, Gaetano Contegiacomo, Alessandro Santo Bortone
Aortic injury is a rare but severe complication that may occur during transcatheter aortic valve implantation (TAVI). Few patients with type A dissection are treated surgically because of the high rate of postoperative mortality and neurological complications in this high-risk population; thoracic endovascular aortic repair is rare too, and technically challenging because of the anatomical variations of spiral type A aortic dissection. Sometimes a watchful waiting strategy could be the best solution. We report the case of an acute, extended aortic type A dissection occurred during a TAVI procedure, probably due to the rupture of the dedicated sheath, and conservatively managed...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28397844/valvular-disease-tavi-noninferior-to-surgery-in-intermediate-risk-patients
#18
Gregory B Lim
No abstract text is available yet for this article.
April 11, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28396186/-eight-days-of-nightmares-%C3%A2-octogenarian-patients-experiences-of-postoperative-delirium-after-transcatheter-or-surgical-aortic-valve-replacement
#19
Irene Instenes, Eva Gjengedal, Leslie S P Eide, Karel K J Kuiper, Anette H Ranhoff, Tone M Norekvål
BACKGROUND: Surgical aortic valve replacement (SAVR) and transcatheter aortic valve implantation (TAVI) are increasingly performed in octogenarian patients with severe aortic stenosis (AS), including those with high surgical risk. Postoperative delirium (PD) is a common and serious complication in older patients, characterised by reduced awareness, change in consciousness, disturbance in logical thinking and hallucinations. METHODS: To explore how octogenarian patients experienced PD, a qualitative study was conducted including five women and five men between 81 and 88 years...
March 20, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28395995/impact-of-technological-changes-on-tavi-outcomes-for-better-for-worse-or-no-change
#20
Ganesh Manoharan
No abstract text is available yet for this article.
April 5, 2017: Revista Española de Cardiología
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